A model for predicting the overall survival of gastroenteropancreatic neuroendocrine neoplasms after surgery

Abstract

Background

The increase in the incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NENs) and refined morphological imaging techniques have led to a rise in the number of patients undergoing surgery. However, there is still a paucity of objective, clinically reliable and personalized tools to evaluate patient prognosis.

Materials and methods

We identified patients from the Surveillance, Epidemiology, and End Results (SEER) database who underwent surgery for GEP-NEN from 1975 to 2018. The predictors associated with OS were investigated by Multivariate Cox proportional hazards (PHs) regression analysis in the primary cohort; a prognostic nomogram was then built based on the multivariate analysis results. The performance of the nomogram was assessed by Harrell's concordance index (C-index) and calibration curve and compared with the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.

Results

A total of 45,889 patients were enrolled in our study; 32,321 were included in the primary cohort, and 13,568 were included in the validation cohort. A nomogram incorporating Age, Differentiation, M staging, and AJCC staging was subsequently built based on the multivariate analysis. The C-index (0.833 for the primary cohort and 0.845 for the validation cohort) and calibration curves indicated good discriminative ability and calibration of the nomogram. Further analysis demonstrated that the nomogram had superior discriminatory ability than the AJCC staging system (C-index= 0.706).

Conclusion

The proposed nomogram showed excellent prediction with good calibration and discrimination, which can be used to make well-informed and individualized clinical decisions regarding the clinical management of GEP-NENs.

Keywords:

• Gastroenteropancreatic
• neuroendocrine neoplasms
• SEER program
• nomogram
• prediction

Disclosure statement

The authors declare no conflicts of interest.

Data availability statement

The data analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by a grant from School level scientific research project of Youjiang Medical College for Nationalities in 2021 [No. yy2021sk044] and self-financing project of Traditional Chinese Medicine Administration of Guangxi Zhuang Autonomous Region [No. GZZC2020234].